The role of shame in alcohol dependence: a review of the literature

Alcohol-related disorders are a priority public health issue, because of their frequency, the severity of the harm they cause – whether health-related or social – and because they concern both the subjects and those around them. The study of the relationship with alcohol in the population is generally focused on social, family and environmental factors, but little research in France has considered emotionality as a factor associated with alcohol consumption. The main objective of this work is to review the literature on the importance of emotional factors, such as shame and guilt, in problem drinking. We explored the role of emotions in alcohol dependence. The results highlight shame as a factor of vulnerability and as an aggravating factor in alcohol dependence. Shame is recognized as a factor in the emergence and maintenance of problem drinking, while guilt appears as a protective factor. A propensity to feel shame is characteristic of individuals with an addiction to alcohol. It is therefore essential to take into account shame, as playing a major role in the problematic consumption of alcohol, in the prevention and management of this behaviour. Interventions focused on improving the individual’s ability to regulate his or her emotions through the development of coping mechanisms could be effective in the prevention or treatment of alcohol dependence. Individuals subject to shame would then be less likely to use alcohol as a coping strategy.